Left Atrial Longitudinal Strain: Early Alterations in Young Patients with Mild Hypertension

pp. 126-132

Abstract

Objectives: The aim of this study was to evaluate early changes in left atrial longitudinal strain based on speckle tracking and the atrial stiffness index in patients with mild hypertension.
Methods: One hundred and one patients, 30 to 50 years of age, were prospectively enrolled in the study: 32 healthy sedentary patients (Group 1), 35 healthy recreational athletes (Group 2) and 34 mild hypertensive patients (Group 3). Sixty eight patients were men (67.3%). Conventional echocardiographic assessments were performed, color tissue Doppler and lateral and septal pulsed tissue Doppler were recorded and atrial volume was calculated. Left ventricular strain and strain rate and left atrial peak strain during the reservoir period were obtained by speckle tracking. The atrial stiffness index was calculated based on the (E/e)/peak atrial strain ratio. Data was analyzed using ANOVA followed by the Bonferroni test. A p value <0.01 was considered statistically significant.
Results: The E/A ratio and the tissue e wave velocity were higher and the E/e ratio was lower in the athlete group. Left ventricular mass index did not show statistical differences among groups. Left atrial volume was higher in athletes without attaining significant difference. In hypertensive patients, atrial strain was lower (36.94 ± 7.71 vs. 46.17 ± 10.05 in Group 1 and 46.80 ± 8.44 in Group 2; 95% CI 3.96-14.47; p <0.0001) and the stiffness index was higher (30.49 ± 11.93 vs. 19.94 ± 8.12 in Group 1 and 18.99 ± 5.88 in Group 2; 95% CI 5.05-16.05; p <0.0001).
Conclusions: Left atrial longitudinal strain during the reservoir period and the atrial stiffness index are altered in patients with mild controlled hypertension before the detection of other echocardiographic changes.